Another victim from attacks on U.N.-backed anti-polio teams in Pakistan died on Thursday, bringing the three-day death toll in the wave of assaults on volunteers vaccinating children across the country to nine, officials said.

Hilal Khan, 20, died a day after he was shot in the head in the northwestern city of Peshawar, said health official Janbaz Afridi

Since Monday, gunmen had launched attacks across Pakistan on teams vaccinating children against polio. Six women were among the nine anti-polio workers killed in the campaign, jointly conducted with the Pakistani government.

The U.N. World Health Organization suspended the drive until a government investigation was completed.

U.N. Secretary-General Ban Ki-moon called the killings “cruel, senseless and inexcusable.” Speaking at his year-end news conference Wednesday, Ban said the victims were among thousands across Pakistan “working selflessly to achieve the historic goal of polio eradication.”

The suspension of the vaccinations was a grave blow to efforts to bring an end to the scourge of polio in Pakistan, one of only three countries where the crippling disease is endemic.

Azmat Abbas, with UNICEF in Pakistan said the field staff would resume the work when they have a secure working environment.

“This is undoubtedly a tragic setback, but the campaign to eradicate polio will and must continue,” Sarah Crowe, spokeswoman for UNICEF, said Wednesday.

However, local officials in the eastern city of Lahore continued the vaccination on Thursday under police escort, and extended the campaign with a two-day follow-up.

Deputy Commissioner Noorul Amin Mengal said about 6,000 Pakistani government health workers were escorted by 3,000 police as they fanned out across the city.

“It would have been an easy thing for us to do to stop the campaign,” he said. “That would have been devastating.”

No one has claimed responsibility for the attacks but some Islamic militants accuse health workers of acting as spies for the United States and claim that the vaccine makes children sterile.

Taliban commanders in the country’s troubled northwest tribal region have also said the vaccinations can’t go forward until the U.S. stops drone strikes in Pakistan.

The insurgent opposition to the campaign grew last year, after it was revealed that a Pakistani doctor ran a fake vaccination program to help the CIA track down and kill Al Qaeda founder Usama bin Laden, who was hiding in the town of Abbottabad in the country’s northwest.

Prevention efforts against polio have managed to reduce the number of cases in Pakistan by around 70 percent this year, compared to 2011, but the recent violence threatens to reverse that progress.

Pakistanis for Peace Editor’s Note– Less than a week since the tragedy in Newtown Connecticut and the death of so many innocent children, we see the ill effects of the Dr Shakil Afridi incident whereby undercover CIA agents using Pakistani doctor under the guise of a polio vaccination program infiltrated and eventually found where OBL was being hidden. The great thing was that we got and killed the bastard.

The negative consequences of this however is now evident as we risk putting up to 33 million Pakistani children in harm’s way as they may not get their polio vaccinations due to Taliban distrust of any medical worker as being a foreign agent. These are horrible consequences and 1 life is not worth 33 million. Very dismayed with the current situation and hoping the Pakistani and American governments can provide better security to all medical teams and doctors if the Pakistani children are to get their critical polio vaccines.

India will celebrate a full year since its last reported case of polio on Friday, a major victory in a global eradication effort that seemed stalled just a few years ago.

If no previously undisclosed cases of the crippling disease are discovered, India will no longer be considered polio endemic, leaving only Pakistan, Afghanistan and Nigeria on that list.

“This is a game changer in a huge way,” said Bruce Aylward, head of the World Health Organization’s global polio campaign.

The achievement gives a major morale boost to health advocates and donors who had begun to lose hope of ever defeating the stubborn disease that the world had promised to eradicate by 2000.

It also helps India, which bills itself as one of the world’s emerging powers, shed the embarrassing link to a disease associated with poverty and chaos, one that had been conquered long ago by most of the globe.

The government cautiously welcomed the milestone as a confirmation of its commitment to fighting the disease and the 120 billion rupees ($2.4 billion) it has spent on the program.

“We are excited and hopeful. At the same time, vigilant and alert,” Health Minister Ghulam Nabi Azad said in a statement. Azad warned that India needed to push forward with its vaccination campaign to ensure the elimination of any residual virus and to prevent the import and spread of virus from abroad.

The polio virus, which usually infects children in unsanitary conditions, attacks the central nervous system, sometimes causing paralysis, muscular atrophy, deformation and, in some cases, death.

With its dense population, poor sanitation, high levels of migration and weak public health system, India had been seen as “the perfect storm of polio,” Aylward said. Even some vaccinated children fell ill with the virus because malnutrition and chronic diarrhea made their bodies too weak to properly process the oral vaccine.

In 2009, India had 741 cases. That plunged to 42 in 2010. Last year, there was a single case, an 18-month-old girl named Ruksana Khatun who fell ill in West Bengal state Jan. 13. She was the country’s last reported polio victim.

Part of the sudden success is credited to tighter monitoring that allowed health officials to quickly hit areas of outbreaks with emergency vaccinations. Part is also attributed to the rollout of a new vaccine in 2010 that more powerfully targeted the two remaining strains of the disease.

Under the $300 million-a-year campaign the government runs with help from the WHO and UNICEF, 2.5 million workers fan out across the country twice a year to give the vaccine to 175 million children.

They hike to remote villages, wander through trains to reach migrating families and stop along roadsides to vaccinate the homeless.

Philanthropist Bill Gates, whose foundation has made polio eradication a priority, hailed India’s achievement as an example of the progress that can be made on difficult development problems.

“Polio can be stopped when countries combine the right elements: political will, quality immunization campaigns and an entire nation’s determination. We must build on this historic moment and ensure that India’s polio program continues to move full-steam ahead until eradication is achieved,” he said in a statement.

Health officials are working to make polio the second human disease eradicated, after smallpox. But while smallpox carriers were easy to find because everyone infected developed symptoms, only a tiny fraction of those infected with the polio virus ever contract the disease. So while no one in India is reported to have suffered from polio in a year, the virus — which travels through human waste — could still be lingering.

That’s why the country will not be certified as completely polio-free until at least three full years pass without a case. And it is why public health advocates warn against complacency in the massive vaccination efforts.

“We are at a threshold. If we take a long step, we may be in trouble,” said Dr. Yash Paul, a pediatrician in the northern city of Jaipur who was a member of the Indian Academy of Pediatrics’ polio eradication committee until it was dismantled last year because the academy felt it was no longer needed.

Paul also appealed to public health officials to begin switching from the oral vaccine, which is easy to administer but contains live virus that can cause the disease in rare cases, to an injectible vaccine that uses dead virus.

The last time a country came off the endemic list was Egypt in 2006. If India succeeds in getting removed from the list in the coming weeks, only Pakistan, Afghanistan and Nigeria will remain. All three saw a rise in cases last year over 2010, and Pakistan is suffering a particularly explosive outbreak, Aylward said.

In addition, 22 other countries that had eradicated the disease suffered new outbreaks. However, some of those outbreaks stemmed from polio imported from India, so getting rid of the virus here is expected to lessen such outbreaks in the future.

Dr. Donald Henderson, who headed WHO’s smallpox eradication program and had long been skeptical of the possibility of eradicating polio, said Thursday he was now hopeful the disease could be conquered across the world by the end of next year.

“You look at a series of dominoes, this is the big one. The others are definitely easier. If we can do it in India, than I’m more optimistic that we can do it in these other countries,” he said. “I’m celebrating a bit. I’ll certainly drink a glass tomorrow … and keep my fingers crossed.”

Aylward hopes India’s success will spur donors to dedicate more money to the polio fight, partly because full eradication could free up funds for other global health issues.

The WHO program needs another $500 million to fund operations for the rest of the year, and some programs could run out of funding by March, he said.

“If we fail at this point, it’s an issue of will,” he said.

Pakistanis for Peace Editor’s Note– Congratulations to India on a great achievement. Despite massive poverty and numerous internal problems, India is working towards the betterment of its people, something Pakistan can learn a great deal from~

For a symptom of Pakistan’s problems, consider the spread of poliomyelitis. This week brought the 115th confirmed case of polio, a crippling and at times fatal disease passed on virally, mainly through bad hygiene. The tally is well up on last year.

In most countries polio is barely a memory. Rich countries had largely eliminated it by the 1970s, and many poor countries soon followed suit. Three decades ago the world saw an estimated 400,000 polio cases a year. Thanks to a cheap and effective vaccine, administered by two drops into a child’s mouth and washed down with dollops of public and private money, the annual global number is now roughly 1,000.

Only in South Asia and Nigeria is it still endemic, though it occasionally flares elsewhere. Since even wretched countries such as Sudan and Myanmar are rid of polio, doctors dream it could follow smallpox and rinderpest to become the third disease wiped from the planet. For hope, look at India. Last year it had just 44 cases of polio, down from an estimated 250,000 three decades ago. Sarah Crowe, of UNICEF in Delhi, credits “one of the biggest mass mobilisations ever for public health”. This year teams of workers headed to train stations, schools and villages, mostly in Bihar and Uttar Pradesh, dosing children with vaccines and promoting habits like soapy hand-washing. Pitiful levels of sanitation persist: fewer Indians (about 50%) have toilets than have mobile phones. But this health campaign is working.

By contrast Pakistan flounders, even though the president, Asif Zardari, declared a national polio emergency in January and received help from the United Nations and the Gates Foundation. “Definitely the cases are on the rise”, says a glum Dr Altaf Bosan, who heads the government campaign.

Blame insecurity most. Three-quarters of last year’s cases were in conflict-ridden areas. The ignorance of religious leaders does not help, with their suspicion of foreign ways. Nor does poor government management. The World Health Organisation thinks that over 200,000 Pakistani children missed their polio vaccinations in the past couple of years. The worst-affected spots are Baluchistan, beset by sectarian massacres and police killings, and the unstable Federally Administered Tribal Areas near the Afghan border. Southern Sindh, deluged by two years of floods, has also been hit.

As more people migrate—because of violence, floods or economic need—the virus has travelled north, to Khyber Pakhtunkhwa, Gilgit-Baltistan and beyond. Ten polio cases reported last month in the Chinese region of Xinjiang, which borders Pakistan, were the first in China since 1999. Eastern Afghanistan also struggles with eradication, given insecurity and its porous borders. But the heart of the problem is Pakistan. Officials conceded in January that the country could be “the last remaining reservoir of endemic poliovirus transmission in the world, and the only remaining threat to achieving global polio eradication.” That is no distinction to savour.

Several Pakistani news outlets today are dissecting a troubling finding from the U.N. Children’s Fund: the 63 cases of polio diagnosed in the country so far this year are nearly double the 36 detected during the same period last year. The highly contagious viral disease, which attacks the nervous system and can cause paralysis or even death, is most evident in the province of Balochistan and has now spread to other areas that haven’t been infected for the past five years. The U.N., which is trying to eradicate the disease by delivering oral vaccines to children, says that these findings suggest Pakistan could be the “last polio reservoir worldwide”–the country standing in the way of eliminating only the second global epidemic disease after smallpox.

This isn’t the first time Unicef has made the claim. In a 2003 report, for example, the organization called Pakistan “polio’s last frontier.” But what’s particularly troubling now is that while the number of cases is dropping in India, Nigeria, and Afghanistan–which, along with Pakistan account for over 90 percent of cases–the disease is spreading in Pakistan (in fact Pakistani President Asif Ali Zardari has declared polio a national emergency). Pakistan’s Express-Tribune cites administrative blunders, resistance of local populations, security challenges for vaccination teams, and Pakistan’s proximity to polio-infected Afghanistan as reasons why the country appears to be losing a battle against polio that “we can simply not afford to lose.” Other reports say anti-vaccine messages from radical clerics and the absence of a national ministry of health are also to blame. The recent revelation that the CIA set up a fake vaccination program in Pakistan to collect DNA from Osama bin Laden’s family members, Reuters notes, may only make immunization drives more difficult.

All that being said, Pakistan isn’t the only obstacle preventing the international community from finally eradicating polio. In an April report, the Global Polio Eradication Initiative announced that the project, which was launched by Unicef and other organizations, didn’t have the funding necessary to reach its goal of stamping out the last remnants of the disease by 2012. The report also noted that polio had reappeared in four disease-free countries–Chad, Angola, Democratic Republic of Congo and South Sudan–and called the state of Kano in northern Nigeria, where rumors were circulating that the polio vaccine would sterilize children, “a smouldering risk that could yet undermine the whole eradication effort.”